Schedule GI Procedures Before Health Insurance Deductible Resets

You should never delay urgent medical procedures, but you could save money by scheduling elective and screening procedures after you have met your deductible.

Preventative Appointments and Colon Cancer Screenings

Have you ever considered waiting until the last quarter of the calendar year to schedule a colon cancer screening or GI procedure? Annual well visits and screenings are usually covered at 100 percent under most insurance plans, but labs and diagnostic testing fees are often the patient’s responsibility. Waiting until you have met your deductible means that additional tests and labs may be covered, or at least, may be more affordable.

A colonoscopy is one procedure that can be less expensive if you have met your deductible. Under most private insurance plans and Medicare, colonoscopy screenings are covered at 100 percent for adults between ages 50 and 75. Because young-onset colon cancer incidence is steadily increasing, the American Cancer Society recommends screening colonoscopies starting at age 45. If you are under 50 and choose to have a screening colonoscopy, your cost-sharing responsibility could be much lower if you have met your deductible.

Diagnostic Colonoscopies

If you have a history of polyps or colon cancer, or you receive a positive result from another colon cancer screening test, your colonoscopy likely will be considered diagnostic. It can make financial sense to schedule a diagnostic colonoscopy after meeting your deductible.

The amount that you will pay for the colonoscopy will depend on whether you have met your deductible or not. If you schedule the procedure at the end of the year when you have already met your deductible, you may not be responsible for any out-of-pocket costs. However, if you wait until January, when your deductible resets to zero, you could be subject to a physician fee, facility fee and laboratory diagnostic fee.

Elective GI Procedures

You could also save money by scheduling other GI procedures at the end of the calendar year. Diagnostic testing and treatments for certain digestive conditions are not considered urgent and can be scheduled at a time that is most convenient for the patient. If your GI doctor has suggested a test, lab or procedure to improve your digestive health, it is most cost-efficient to schedule the appointment when you are close to meeting your deductible. Do not delay too long, though. With the approaching holidays, appointment availability will rapidly diminish, so look over your calendar and call soon.

Before you schedule your GI procedure, call your insurance provider. Request a cost estimate for the procedure and ask how close you are to meeting your deductible. Having all the facts can help you plan effectively and can stretch your healthcare spending dollars.